CAJ | 학술논문

目的研究采用指固有动脉串联逆行岛状皮瓣修复相邻指体指端套脱伤的临床疗效.方法 2009年3月至2011年5月,我院采用指固有动脉串联逆行岛状皮瓣修复相邻指体指端套脱伤11例.示指5例,中指3例,环指2例,小指1例.皮肤缺损面积为3.0 cm×2.2 cm～5.5 cm×4.5 cm.结果本组1例术中皮瓣在游离过程中即发生血管痉挛,经局部滴注罂粟碱及生理盐水热敷后痉挛解除；2例皮瓣术后出现水泡,1周后消失；其余皮瓣均顺利存活.术后随访6～24个月,平均12个月.皮瓣外形、质地均良好,恢复部分感觉功能.参照中华医学会手外科学会上肢部分功能评定试用标准评定:优6例,良4例,可1例；优良率90.9％.结论指固有动脉串联逆行岛状皮瓣修复指端套脱伤,手术操作简便,疗效满意.
목적 연구채용지고유동맥천련역행도상피판수복상린지체지단투탈상적림상료효.방법 2009년3월지2011년5월,아원채용지고유동맥천련역행도상피판수복상린지체지단투탈상11례.시지5례,중지3례,배지2례,소지1례.피부결손면적위3.0 cm×2.2 cm～5.5 cm×4.5 cm.결과 본조1례술중피판재유리과정중즉발생혈관경련,경국부적주앵속감급생리염수열부후경련해제；2례피판술후출현수포,1주후소실；기여피판균순리존활.술후수방6～24개월,평균12개월.피판외형、질지균량호,회복부분감각공능.삼조중화의학회수외과학회상지부분공능평정시용표준평정:우6례,량4례,가1례；우량솔90.9％.결론 지고유동맥천련역행도상피판수복지단투탈상,수술조작간편,료효만의.
Objective To investigate the effectiveness of using digital artery tandem reverse island flaps to repair fingertip degloving injuries of the adjacent fingers.Methods Between March 2009 and May 2011,11 cases of degloving injuries of the fingertip were treated using this procedure.Among these cases 5 involved the index finger,3 involved the middle finger,2 involved the ring finger and 1 involved the little finger.The sizes of skin and soft tissue defect ranged from 3.0 cm× 2.2 cm to 5.5 cm × 4.5 cm.The two island flaps were harvested along the same digital artery course and transferred to cover defects of the fingertip of adjacent fingers.Results Vascular spasm occurred in 1 case during flap harvesting which was alleviated by topical application of papaverine and warm saline.Postoperative blister appeared in 2 cases but disappeared after one week.The other flaps survived uneventfully and the wounds healed by first intention.The follow-up period ranged from 6 to24 months,being 12 months on average.All flaps presented the satisfactory shape and texture and recovered some sensation.The flexion and extension function of wounded fingers recovered to normal.According to the functional assessment criteria of the upper limb formulated by the Hand Surgery Society of Chinese Medical Association,the outcomes were graded as excellent in 6 cases,good in 4 cases,and fair in 1 case,with an excellent and good rate of 90.9％.Conclusion The digital artery tandem reverse island flaps for repairing fingertip degloving injury is a simple and effective procedure.